Chen Jia-Jin, Kuo George, Hung Chi-Chih, Lin Yu-Feng, Chen Yung-Chang, Wu Ming-Ju, Fang Ji-Tseng, Ku Shih-Chi, Hwang Shang-Jyh, Huang Yen-Ta, Wu Vin-Cent, Chang Chih-Hsiang
Department of Nephrology, Linkou Chang Gung Memorial Hospital, Taipei, Taiwan.
Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Formos Med Assoc. 2021 Jul;120(7):1424-1433. doi: 10.1016/j.jfma.2021.02.013. Epub 2021 Mar 9.
Risk and prognostic factors for acute kidney injury (AKI) have been published in various studies across various populations. We aimed to explore recent advancements in and provide updated recommendations on AKI risk stratification and information about local AKI risk factors. The Taiwan Acute Kidney Injury Task Force reviewed relevant recently published literature and reached a consensus after group meetings. Systemic review and group discussion were performed. We conducted a meta-analysis according to the PRISMA statement for evaluating the diagnostic performance of the furosemide stress test. Several risk and susceptibility factors were identified through literature review. Contrast-associated AKI prediction models after coronary angiography were one of the most discussed prediction models we found. The basic approach and evaluation of patients with AKI was also discussed. Our meta-analysis found that the furosemide stress test can be used as a prognostic tool for AKI progression and to identify patients with AKI who are at low risk of renal replacement therapy. Factors associated with de novo chronic kidney injury or renal non-recovery after AKI were identified and summarized. Our review provided practical information about early identification of patients at high risk of AKI or disease progression for Taiwan local clinics.
急性肾损伤(AKI)的风险和预后因素已在针对不同人群的各类研究中发表。我们旨在探讨AKI风险分层的最新进展,并提供关于AKI风险分层的最新建议以及当地AKI风险因素的信息。台湾急性肾损伤特别工作组回顾了近期发表的相关文献,并在小组会议后达成了共识。进行了系统评价和小组讨论。我们根据PRISMA声明进行了一项荟萃分析,以评估呋塞米应激试验的诊断性能。通过文献回顾确定了几个风险和易感因素。冠状动脉造影术后对比剂相关AKI预测模型是我们发现的讨论最多的预测模型之一。还讨论了AKI患者的基本评估方法。我们的荟萃分析发现,呋塞米应激试验可作为AKI进展的预后工具,并用于识别接受肾脏替代治疗风险较低的AKI患者。确定并总结了与新发慢性肾损伤或AKI后肾功能未恢复相关的因素。我们的综述为台湾当地诊所提供了关于早期识别AKI高危患者或疾病进展患者的实用信息。